Smokers now face another risk from their habit: it could cost them a shot at a job.

More hospitals and medical businesses in many states are adopting strict policies that make smoking a reason to turn away job applicants, saying they want to increase worker productivity, reduce health care costs and encourage healthier living.

The policies reflect a frustration that softer efforts ? like banning smoking on company grounds, offering cessation programs and increasing health care premiums for smokers ? have not been powerful-enough incentives to quit.

The new rules essentially treat cigarettes like an illegal narcotic. Applications now explicitly warn of ?tobacco-free hiring?, job seekers must submit to urine tests for nicotine and new employees caught smoking face termination.

This shift ? from smoke-free to smoker-free workplaces ? has prompted sharp debate, even among anti-tobacco groups, over whether the policies establish a troubling precedent of employers intruding into private lives to ban a habit that is legal.

?If enough of these companies adopt theses policies and it really becomes difficult for smokers to find jobs, there are going to be consequences,? said Michael Siegel, a professor at the Boston University School of Public Health, who has written about the trend. ?Unemployment is also bad for health.?

Smokers have been turned away from jobs in the past ? prompting more than half the states to pass laws rejecting bans on smokers ? but the recent growth in the number of companies adopting no-smoker rules has been driven by a surge of interest among health care providers, according to academics, human resources experts and tobacco opponents.

There is no reliable data on how many businesses have adopted such policies. But people tracking the issue say there are enough examples to suggest the policies are becoming more mainstream, and in some states courts have upheld the legality of refusing to employ smokers.

For example, hospitals in Florida, Georgia, Massachusetts, Missouri, Ohio, Pennsylvania, Tennessee and Texas, among others, stopped hiring smokers in the last year and more are openly considering the option. ?We?ve had a number of inquiries over the last 6 to 12 months about how to do this,? said Paul Terpeluk, a director at the Cleveland Clinic, which stopped hiring smokers in 2007 and has championed the policy.